Most of the primary research is NIH money handed out to university researchers. But then easily as much money is spent in human trials and that’s privately funded.

So? A tiny fraction. Of the one billion development cost, how much is early research, done in universities?

You have no idea about this industry. Or for the noob: development costs are tiny compared to costs in clinical trials.

There are some interesting compounds. Dichloroacetate for example. Not patent protected. Feel free to start your own clinical trial tomorrow. :-)

It is people risking money in order to earn huge profits that makes the system work. The government spends enormous amounts of money on basic research, much of it ineffectively IMO. Bringing cutting edge therapies to the market was, is, and always will be through the entrepreneurial system. Believing bureaucrats can accomplish the same thing is naïveté.